CBG MONITORINGCBG MONITORINGCBG MONITORING

CBG MONITORING

1. Obtaining a capillary blood sample F0r glucose testing (CBG)

2. Definition Blood glucose monitoring provides information about how the body is controlling glucose metabolism. Controlling patient’s blood glucose levels reduces complications, saves lives, shortens hospital stays, and reduces health care costs. It is indicated in the care of patients with many conditions, including diabetes, seizures, enteral and parenteral feeding, liver disease, pancreatitis, head injury, stroke, alcohol, drug intoxication, and sepsis.

3. EQUIPMENT Blood glucose meter Sterile lancet Cotton balls or gauze squares Testing strips for meter Nonsterile gloves Alcohol swab or soap and water

4. ASSESSMENT Assess patient’s history for indicating necessitating the monitoring of blood glucose levels, such as high-carbohydrate feedings, history of diabetes mellitus, or corticosteroid therapy. Assess the patient’s knowledge about monitoring blood glucose. Assess the area of the skin to be used for testing; avoid bruised and open areas.

5. OBJECTIVES To measure blood glucose accurately without adverse effect. Patient will be free from injury. Patient will demonstrate a blood glucose level within acceptable parameters. Patient will demonstrate ability to participate in monitoring. Patient will verbalize increased comfort with procedure.

6. Procedure STEPS RATIONALE Check the patient’s medical record or nursing plan of care for monitoring schedule. You may decide that additional testing is indicated based on nursing judgment. This confirms scheduled times for checking blood glucose. Independent nursing judgment may lead to the decision to test more frequently, based on patient’s condition. 2. Gather equipments . This provides an organized approach to the task. 3. Close curtains around bed and close door if possible. Closing the curtain or door provides for patient privacy.

7. 4. Identify the patient. Explain procedure to patient and instruct patient about the need for monitoring blood glucose. Identifying the patient ensures the right patient receives the intervention and helps prevent errors. Explanation helps to alleviate anxiety and facilitate cooperation.   5. Perform hand hygiene. Put on sterile gloves. Hand hygiene deters the spread of microorganisms. Gloves protect the nurse from exposure to blood and body fluids. 6. Turn the monitor on. Allows monitor to be used. 7. Enter the patient’s identification number, if required, according to facility policy. Allows electronic storage and accurate identification of patient data.

8. 8. Prepare lancet using aseptic technique. Aseptic techniques maintains sterility. 9. Remove test trip from the vial. Recap container immediately. Test strips also com individually wrapped. Turn monitor on. Check that code number for the strip matches the code number on monitor screen. Immediately recapping protects strips from exposure to humidity, light, and discoloration. Matching code numbers on the strip and glucose monitor ensures that the machine is calibrated correctly. 10. Insert the strip into the meter according to directions for that specific device. Correctly inserted strip allows meter to read blood glucose level accurately. 11. For adult, massage side of the finger toward puncture site. Massage encourages blood to flow to the area. 12. Have patient wash hands with soap and warm water and dry thoroughly. Alternately, the skin may be cleansed with alcohol swab. allow skin to dry completely. Washing with soap and water or alcohol cleanses the puncture site. Warm water also helps to cause vasodilation. Alcohol can interfere with accuracy of results if not completely dried.

9. 13. Hold lancet perpendicular to skin and pierce site with lancet. Holding lancet in proper position facilitates proper skin penetration. 14. Wipe away first drop of blood with gauze square or cotton ball if recommended by manufacturer of monitor. Manufacturer recommend discarding the first drop of blood, which may be contaminated by serum or cleansing product, producing inaccurate reading. 15. Encourage bleeding by lowering hand, making use of gravity. Lightly stroke the finger, if necessary, until sufficient amount of blood has formed to cover the sample area on the strip, based on monitor requirements. Take care not to squeeze the finger, not to squeeze at puncture site, or not to touch the puncture site or blood. An appropriate-sized droplet facilitates accurate test results. Squeezing can cause injury to the patient and alter the test result. 16. Gently touch the drop of blood to pad on test strip without smearing it. Smearing blood on the strip may result in inaccurate test results.

10. 17. Press time button if directed by manufacturer. Correct timing produces accurate results. 18. Apply pressure to puncture site with a cotton ball. Do not use alcohol wipe. Pressure causes hemostasis. Alcohol stings and may prolong bleeding. 19. Read blood glucose results and document appropriately at bedside. Inform patient of test result.   20. Turn meter off, remove test strip and dispose of supplies appropriately. Place lancet in sharps container. Proper disposal prevents exposure to blood and accidental needlesticks. 21. Remove gloves and perform hand hygiene. Hand hygiene prevents the spread of microorganisms.

11. EVALUATION Patient’s blood glucose was measured accurately without adverse effect; blood glucose level was within acceptable limits. Patient participated in monitoring. Patient verbalized comfort with the procedure